Brief Article
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World J Gastroenterol. Nov 21, 2013; 19(43): 7696-7700
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7696
Laparoscopy-assisted percutaneous endoscopic gastrostomy enables enteral nutrition even in patients with distorted anatomy
Adam Hermanowicz, Ewa Matuszczak, Marta Komarowska, Elzbieta Jarocka-Cyrta, Jerzy Wojnar, Wojciech Debek, Konrad Matysiak, Stanislaw Klek
Adam Hermanowicz, Ewa Matuszczak, Marta Komarowska, Elzbieta Jarocka-Cyrta, Jerzy Wojnar, Wojciech Debek, Department of Pediatric Surgery, Medical University of Bialystok, 15-001 Bialystok, Poland
Konrad Matysiak, Department of Gastroenterology and Oncology and Plastic Surgery, Medical University of Poznan, 60-015 Poznań, Poland
Stanislaw Klek, General and Oncology Surgery Unit, Stanley Dudrick’s Memorial Hospital, 32-050 Skawina, Poland
Author contributions: Hermanowicz A and Klek S coordinated the trial, they were responsible for the study conception and contributed to the experimental design, data interpretation and writing of the manuscript; all the authors critically revised the intellectual content of the study and contributed to the writing of the manuscript, the data and statistical analyses and the data collection.
Correspondence to: Stanislaw Klek MD, PhD, Professor, General and Oncology Surgery Unit, Stanley Dudrick’s Memorial Hospital, 15 Tyniecka Street, 32-050 Skawina, Poland. klek@poczta.onet.pl
Telephone: +48-12-4248007 Fax: +48-12-4248007
Received: August 15, 2013
Revised: September 19, 2013
Accepted: September 29, 2013
Published online: November 21, 2013
Processing time: 124 Days and 17 Hours
Abstract

AIM: To analyzed whether laparoscopy-assisted percutaneous endoscopic gastrostomy (PEG) could be a valuable option for patients with complicated anatomy.

METHODS: A retrospective analysis of twelve patients (seven females, five males; six children, six young adults; mean age 19.2 years) with cerebral palsy, spastic quadriparesis, severe kyphoscoliosis and interposed organs and who required enteral nutrition (EN) due to starvation was performed. For all patients, standard PEG placement was impossible due to distorted anatomy. All the patients qualified for the laparoscopy-assisted PEG procedure.

RESULTS: In all twelve patients, the laparoscopy-assisted PEG was successful, and EN was introduced four to six hours after the PEG placement. There were no complications in the perioperative period, either technical or metabolic. All the patients were discharged from the hospital and were then effectively fed using bolus methods.

CONCLUSION: Laparoscopy-assisted PEG should become the method of choice for gastrostomy tube placement and subsequent EN if PEG placement cannot be performed safely.

Keywords: Percutaneous endoscopic gastrostomy; Laparoscopy-assisted percutaneous endoscopic gastrostomy; Severe kyphosis; Malnutrition; Interposed organs

Core tip: Enteral nutrition (EN) is a life-saving procedure, preventing complications associated with malnutrition. The best solution for EN is percutaneous endoscopic gastrostomy (PEG). In some cases, however, creating such access is impossible. In those cases, laparoscopy-assisted PEG should become the method of choice for gastrostomy tube placement and subsequent EN if PEG placement cannot be performed safely.